24例难治性颞叶癫痫手术患者病例分析  

Analysis of 24 cases of intractable temporal lobe epilepsy surgery

作　　者：张豪正 李堃 于华凤[4] 王广新 孟姣 陈洁[1] ZHANG Haozheng;LI Kun;YU Huafeng;WANG Guangxin;MENG Jiao;CHEN Jie(Department of Maternal and Child Health,School of Public Health,Shandong University,Jinan 250012,China;Pediatric Research Institute,Jinan Children's Hospital,Jinan,Shandong 250022,China;Department of Neurology,Changguo Hospital,Zibo,Shandong 250022,China;Pediatric Internal Medicine Department,Jinan Children's Hospital,Jinan,Shandong 250022,China;Institute of Translational Medicine,Jinan Central Hospital Affiliated to Shandong University,Jinan,Shandong 250022,China;Pathology Department,Jinan Children's Hospital,Jinan,Shandong 250022,China)

机构地区：[1]山东大学公共卫生学院儿少卫生与妇幼保健系,济南250012 [2]济南市儿童医院儿科医学研究所,济南250022 [3]山东省淄博昌国医院神经科,淄博255000 [4]济南市儿童医院儿内科,济南250022 [5]济南市中心医院专科转化研究中心,济南250013 [6]济南市儿童医院病理科,济南250022

出　　处：《癫痫杂志》2021年第1期34-38,共5页Journal of Epilepsy

基　　金：山东省自然科学基金项目(ZR2019MH043);济南市临床科技创新计划(201705031)。

摘　　要：目的了解难治性颞叶癫痫手术治疗的现状和预后效果。方法回顾性分析2011年4月—2014年6月于淄博昌国医院经手术治疗且临床及随访资料完整的24例难治性颞叶癫痫手术患者,其中男14例,女10例。年龄16~44岁,平均(24.40±6.26)岁,平均病程(12.50±8.42)年。分析患者的临床特点和预后情况。结果 24例患者均有海马硬化,行"颞前叶及颞内侧结构切除术"。经过5~7年的随访,术后癫痫发作情况达到EngelⅠ级20例(83.3%),EngelⅡ级2例(8.3%),EngelⅣ级2例(8.3%)。结论 24例患者以海马硬化和皮质发育不良多见,手术治疗效果较好。临床上为改善难治性癫痫患者预后,应视情况尽早行手术治疗。Objective To investigate the status and prognosis effect of surgical operation for Temporal lobe epilepsy. Methods Retrospective analyses were performed on 24 patients with intractable temporal lobe epilepsy who were treated by surgery in Zibo Changguo Hospital and had complete clinical and follow-up data, during the period from April 2011 to June 2014. Among them, 14 were male and 10 were female, 16 to 44 years old, the average age was(24.40±6.26)years old, and the average course of disease was(12.50±8.42) years old. The clinical characteristics and prognosis of the patients were analyzed. Results All 24 patients had hippocampal sclerosis and underwent "anterior temporal lobe and medial temporal structural resection". Patients were followed up for 5~7 years, the postoperative epileptic seizure of the patient reached grade Engel Ⅰ in 20 cases(83.3%), grade Engel Ⅱ in 2 cases(8.3%) and grade Engel Ⅳ in 2 cases(8.3%). Conclusion Hippocampal sclerosis and cortical dysplasia were common in 24 patients, and the operation controlling intractable epilepsy was better. In order to improve the prognosis of patients, surgical treatment should be carried out as soon as possible.

关 键 词：难治性癫痫 海马硬化 手术 

分 类 号：R651.1[医药卫生—外科学]